Even if your doctor has formally recommended a surgery, getting authorization from L&I can be challenging for injured workers in…
Who is Charles Peterson, M.D.?
There are multiple physicians named Charles Peterson, nationally, but this article references only that Charles Peterson, MD, who has routinely performed Independent Medical Examinations (“IME exams”) for the Department of Labor & Industries and Self-Insured Employers in the state of Washington. Please note that the entirety of this article is solely the exclusive opinion of its author, Spencer D. Parr, co-founder of Washington Law Center, regarding Dr. Charles Peterson.
In the opinion of Attorney Parr, Dr. Peterson is a biased medical expert who will say what insurance defense interests pay him to say. Defense interests use his Yale education to sound authoritative when they litigate against good people, but having gone to Yale does not make an expert’s opinion truthful. Being a doctor doesn’t make a person a good doctor (nor a good person). Some doctors have figured out that they can commercialize their medical credentials. Defense interests then weaponized their opinions against good people. In the opinion of Attorney Parr, Dr. Peterson’s existence has been weaponized.
The public will, of course, have to decide for itself. Is Dr. Charles Peterson biased against injured workers? Just because an experienced, claimant’s-side Washington workers’ compensation attorney says so doesn’t necessarily make it true (or does it?). Sometimes Dr. Peterson’s opinions unfortunately carry the day in litigation against injured workers. But, let’s also take a look at a particular decision in which an Industrial Appeals Judge frankly called out Dr. Peterson’s opinions as “wrong-headed.” Attorney Spencer D. Parr of Washington Law Center represented:
Read The Decision of Judge Palmer Regarding Charles Peterson MD’s Decisions Here:
On pages 4-5, the judge states that Dr. Charles Peterson had an insufficient foundation, such that his opinion “crumbled away.”
On page 6, the judge states that Dr. Charles Peterson “provided scant detail concerning the symptoms recorded in the preinjury medical records” to support his opinion.
Also on page 6, the judge states that Dr. Charles Peterson “chose to give long narrative answers, liberally salted with opinions he based upon inapplicable legal standards.” The judge then notes how Dr. Peterson cited to a Washington Supreme Court case and asserted it as support for his position while the Washington Supreme Court case simply doesn’t say what this IME doctor asserted that it does. Who would do that other than a biased medical expert paid for their opinion against injured workers?
On page 7, the judge found Dr. Charles Peterson’s understanding of the injured worker’s preinjury symptoms to be inaccurate, or at least less accurate than would be sufficiently persuasive.
On page 8, the judge found that Dr. Charles Peterson failed to consider all required medical analysis, including with respect to preexisting conditions, when assessing the injured worker’s ability to work. The judge explains from pages 7-8 and in later findings of fact and law that the injured worker is temporarily totally disabled during the period in contest.
On page 9, the judge recognized that Dr. Charles Peterson failed to understand the injuries he was asked to assess. He was specifically asked by the Department of Labor & Industries to give opinions about two separate injuries but still failed to recognize (even with this request from the Department, a record review and an IME exam at which he had an opportunity to ask the injured worker directly about the injury history) that there were, in fact, two separate injuries. Oh my.
On page 11, the judge found that Dr. Charles Peterson’s opinion against the injured worker’s rightful claim is “based on his wrong-headed lighting up analysis.” Here, the judge is quite correctly chastising a paid “expert” witness (a mercenary in the legal system) for asserting analysis that was contrary to settled law. “Wrong-headed” doctors like Charles Peterson give opinions that injured workers often feel powerless to fight, since these workers didn’t go to Yale and don’t practice medicine or law. The result is that many injured workers claims are defeated simply by demoralizing and overpowering these good people instead of giving fair consideration to their claims. Biased IME witnesses are one tool by which that improper end is too-often accomplished.
On pages 11-12, the judge notes how Dr. Charles Peterson gave clearly contradictory testimony on the same subject, at one point saying he “didn’t see how” the injured worker’s condition could be causally-related to the claimed injury, but at another point letting it slip that the mechanism of the worker’s injury would be a competent producing cause of the resulting medical condition.
In the end, if you are being sent to an IME examination by Dr. Charles Peterson, or any of the other IME physicians who testify routinely on behalf of defense interests, it’s time for you to consult with an experienced workers’ compensation attorney immediately. If you are an Attending Physician reading this page, do not concur with Dr. Charles Peterson or any of the other so-called “IME” analysts without performing your own careful analysis.
The Legislature of Washington has sadly failed to follow the examples of states like New York and California, to provide our state’s residents with an anti-IME fraud statute in order to help clean up some of the more corrupt aspects of our workers’ compensation scheme.
In the view of Washington Law Center, the following would be appropriate changes that should be made to our Industrial Insurance Act:
- Require IME doctors to certify the contents of their reports under penalty to perjury before submitting them to either the Department or Self-Insured Employers. [Some doctors want to be paid the IME money but don’t want to commit perjury, so they will give more considerate opinions than we sometimes see at present in Washington state. This requirement already exists in both New York and California.]
- Require that no IME report which is unsigned in wet ink may be used to adjudicate a Labor & Industries claim. This rule must be binding on the Department, the Board of Industrial Insurance Appeals and the Courts. [One of the risks of Washington’s system is that IME physicians dictate their reports but never see them again until a year or more later when they testify, and when they can no longer recall if their report is accurate or not. This allows the IME companies to transcribe what the doctors say, compile the report, and then submit this with a saved version of the doctor’s electronic signature. An IME company may deliberately game this system by fraudulently misstating parts of the doctor’s opinion. States like New York have found that this kind of fraud does occur and is a danger to injured workers. New York’s system regulates IME companies and then keeps them more honest by requiring that the doctor review their report after the dictation has been transcribed, certify under penalty of perjury that it is the true and accurate and complete opinion of the doctor, and then the doctor must apply a wet ink (original) signature to the report within 10 days of the IME exam to ensure that the doctor still likely remembers what happened during the exam. No exam report may be utilized, and the expert’s opinion is precluded from evidence, if this protocol has not been followed. It’s easy to follow, so it’s a shame Washington’s legislature hasn’t demanded this reform in protection of our injured workers.]
- Require that if the IME provider intends to indicate that a contended medical condition is “preexisting,” the IME provider must certify that they have reviewed a statement of settled law regarding the adjudication of preexisting conditions (in a format that will be promulgated by the Department with the assistance of the Attorney General’s office), as well as that the provider’s opinion is consistent with the statement of settled law which has been promulgated by the Department. [Too many IME providers, including those from states as far away as Florida and Maine fly to Washington state and then give medical opinions phrased in a way which does not match Washington’s legal requirements, thereby causing excessive error rates in adjudication and resulting in excessive costs for injured workers to vindicate their claims. This practice of bringing in outside medical opinion providers or allowing serial offenders from the local medical community is abusive toward injured workers and wasteful of public resources.]
- Prohibit IME physicians from discussing the contents of their evaluations with either the Department of Labor & Industries or Self-Insured Employers until the injured worker has been served a copy of the IME provider’s written report. Furthermore, this written report must be served on the Department/SIE and the injured worker at the same time. [Too often the IME provider is working in direct communication with the requesting party, while keeping these communications secret and non-transparent to the injured worker. This is done to ensure that the requesting party gets the decision that they want, but then the doctor is not an “independent” medical examiner at all, they are a mere speaking agent of the defense interests. Once everybody understands that the IME provider is the speaking agent of the defense, the possibility of objectivity, or even near-objectivity, essentially disappears. Note that other states, New York in particular, have had this requirement for many years and their workers’ compensation systems have not collapsed or become unfair to defense interests]
- Prohibit the Department and Self-Insured Employers from denying diagnostic studies, tests and other diagnostic medical care that costs less than $1,200 unless the Department or SIE first obtains (within 30 days of the request) a medical expert opinion from a licensed physician, stating expressly that the diagnostic recommendation of the Attending Provider can have no useful benefit in determining claim issues, including the injured worker’s medical needs. [In New York’s workers’ compensation reform of 2007, the value of such a proposition was limited to $1,000. What happened was that MRI providers that previously charged $1200 for an MRI immediately dropped their charge to $999.99 because the lower charge would be authorized without heavy frictions. Washington Law Center advocates a current, presumptive authorization amount of $1200 or less in order to keep our system competitive and up to the costs of inflation. We would expect the same results as were obtained in New York. Specifically, an increased velocity of commerce made the decreased price for the diagnostic studies economically feasible, saving money for the workers’ compensation system while simultaneously rushing benefits to injured workers. Injured workers then got quicker diagnostic care, allowing them to recover faster from their injuries and save even more money for the system over the long term. Washington’s system of using deficient Qualis utilization review, constant and repetitive denials, sending injured workers to obtain recommendations for an MRI, CT, NCV/EMG studies, diagnostic injections, etc., from multiple physicians and specialists while vastly delaying care is ridiculous. This broken system drives Washington claims costs far higher than they should be. It has also increased the average time of recovery unacceptably. The legislature should take notice and adopt common sense reforms already used successfully in other states].
- Limit the total number of IME opinions to three per claim for any claim lasting less than 18 months from the date of injury, and to no more than one additional IME examiner for every year the claim remains open thereafter. An exception to this rule would be that the Department or SIE may obtain an appropriate IME panel during any new reopening application which does not count against the maximum allowed. A further exception would be provided if an Industrial Appeals Judge orders that an additional IME examination is justified under Court Rule 35. [The point of this reform is to allow claims managers to fairly evaluate the claims of injured workers without making injured workers constantly return to IME examiner after IME examiner in a procession designed to harass workers, fatigue their medical providers, delay the injured workers’ receipt of appropriate care, and to unduly advantage the Department and Self-Insured Employers when conflicts arise. IME exams should be used judiciously, not reflexively as they presently are in some cases. The elements of ego and competitiveness have no place in L&I claims management, whereas presently an L&I or SIE/TPA claims manager will get “a thing” for a particular worker’s case and then turn screws by ordering excessive IME exams. In one claim successfully fought by Washington Law Center, the opposing SIE had 12 different physical medicine doctors perform IME examinations, all of which towed the company line, none of which prevailed after incredibly-expensive litigation against our client. These kinds of abuses cannot be tolerated any longer.]
At Washington Law Center, we are thought and litigation leaders. We fight to vindicate out clients’ rights despite the existence of unfair aspects of our state’s workers’ compensation system, including but not limited to the fact that IME abuse is rampant. If you believe an IME examiner has given an incorrect opinion, you are certainly not alone. Until our state’s legislature enacts commonsense IME regulations to improve the quality of opinions injected into our system, please contact one of our experienced workers’ compensation attorneys today. Every case stands or falls on its own merit, so past performance is not a guarantee of future outcome. Still, we do know what we’re doing and we may be able to help you with your L&I claim.